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Al-Taj MA, Al-Hadari MH. Prevalence and drivers of female genital mutilation/cutting in three coastal governorates in Yemen. BMC Public Health 2023; 23:1363. [PMID: 37461020 DOI: 10.1186/s12889-023-16299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 07/12/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Female genital mutilation/cutting (FGM/C), a violation of human rights, remains common in the coastal areas of Yemen. OBJECTIVE This study aimed to identify the prevalence of FGM/C and its risk factors among the youngest daughters in families in the Yemeni coastal areas, as well as the knowledge and attitudes of the local population towards FGM/C. METHODS A cross-sectional survey was conducted among 646 women and 345 men from six districts in three Yemeni coastal governorates between July and September 2020 using a structured questionnaire. Categorical data were described by proportion. The chi-square test was used to identify factors associated with FGM/C. All factors with a p-value of ≤ 0.05 were included in the multivariate analysis. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated in the multivariate logistic regression analysis. RESULTS The prevalence of FGM/C in Yemeni coastal areas was 89.0% (95% CI 84.0%-92.5%) among women and 79.8% (95% CI 73.5%-84.8%) among the youngest daughters in the surveyed families. Nearly two-thirds of women and half of the men recorded a poor knowledge level about the harms of FGM/C. Furthermore, almost two-thirds of both women and men would like to continue the practice of FGM/C. Among women, significant predictors of FGM/C among youngest daughters included advanced maternal age of ≥ 40 years (AOR 7.16, 95% CI 2.73-18.76), mother's desire to continue FGM/C (AOR 8.07, 95% CI 3.64-17.89), and living in a rural area (AOR 3.95, 95% CI 1.51-10.30). Daughters of mothers who did not undergo FGM/C were more protected from FGM/C than those whose mothers had undergone FGM/C (AOR 0.04, 95% CI 0.02-0.09). Among men, the father's desire to continue FGM/C (AOR 15.10, 95% CI 6.06-37.58) was significantly associated with FGM/C among the youngest daughters. CONCLUSION This study confirmed that FGM/C is still prevalent among communities in Yemeni coastal areas. Thus, community-based interventions with a focus on the rural population are vital to improving the awareness of various harms of FGM/C.
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Affiliation(s)
- Mansour Abdu Al-Taj
- Department of Community Medicine, Faculty of Medicine, Sana'a University, Mudbah Street, Sana'a, 773169022, Yemen.
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Rabiepour S, Ahmadi Z. The effect of female circumcision on maternal and neonatal outcomes after childbirth: a cohort study. BMC Pregnancy Childbirth 2023; 23:46. [PMID: 36670393 PMCID: PMC9854179 DOI: 10.1186/s12884-022-05316-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/19/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Circumcision has many side effects and complications on women's lives and affects their physical, mental, and social health. The present study aimed to investigate the effect of female circumcision on maternal and neonatal outcomes. METHODS Methods: A prospective cohort study was performed with 320 pregnant women by convenience sampling (160 individuals were circumcised and 160 were uncircumcised). Circumcision and its level were confirmed using observation. The data relating to demographic, midwifery history, medical history, maternal and neonatal outcomes were compiled using a questionnaire. All Statistical analyses were conducted by SPSS ver. 16.0. P-values less than 0.05 were considered significant. RESULTS The mean age of circumcised women was significantly higher vs. Uncircumcised women (28.92±6.2 vs. 25.42±4.8; P < 0.001). Circumcision was significantly higher in rural compared to urban areas (51.9% vs.18.1%). The level of female education, his parents, spouse, and husband's employment status were significantly associated with circumcision (P < 0.001). 94.4% of uncircumcised nulliparous women and 86.9% of circumcised women experienced Intended Pregnancy (P=0.02). Eighty- five percent of women were circumcision type I. The higher mean duration of the second stage of labor, Second and Third degree of tear, and need for oxytocin in induction were significantly higher among circumcised women (P = 0.03, 0.003, 0.002, respectively). The existence one stage of labor, Second and Third degree of tear, and the need for oxytocin in induction were significantly higher among circumcised women (P = 0.03, 0.003, 0.002, respectively). CONCLUSION These findings underscore that Circumcision a prevalent predictor of poor neonatal outcomes and delivery processes, therefore this circumcised women needs intensive care during delivery.
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Affiliation(s)
- Soheila Rabiepour
- grid.412763.50000 0004 0442 8645Professor Reproductive research center, Urmia university of Medical ScienceUrmia, Urmia, Iran
| | - Zeynab Ahmadi
- Consultation on midwifery, Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran.
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Gombau-Giménez L, Almansa-Martínez P, Suarez-Cortés M, Molina-Rodríguez A, Leal-Costa C, Jiménez-Ruiz I. Obstetric Complications in Women from Sub-Saharan Africa-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10101. [PMID: 36011736 PMCID: PMC9408375 DOI: 10.3390/ijerph191610101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
AIM The aim of this study was to identify and compare birthing complications in women originating from countries where they are at risk (may become victims) of FGM with those of Spanish women, all having given birth from 2012 to 2015 at the "Virgen de la Arrixaca" University Clinical Hospital in Murcia, Spain. METHODS A transversal, observational, quantitative study was carried out, retrospectively, comparing 245 sub-Saharan women originating from countries where FGM is practiced with 490 Spanish women, in terms of obstetric complications. Data collection was performed via electronic clinical records. RESULTS The sub-Saharan women presented higher rates of intrapartum and emergency caesareans, intense postpartum haemorrhages, concurrent episiotomies and tears (2nd and 3rd degree), failed inductions, and non-progressive labours, and a more severe risk of foetal distress when compared with Spanish women. CONCLUSIONS The fact that the sub-Saharan women originating from countries where FGM is practiced presented a greater number of birthing complications than the Spanish women proves the need for Spanish healthcare professionals to receive training towards cultural competency acquisition, in order to provide a multidisciplinary approach, with standardized action protocols focused fundamentally on prevention.
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Affiliation(s)
| | | | | | | | - César Leal-Costa
- Faculty of Nursing, University of Murcia, El Palmar, 30120 Murcia, Spain
| | - Ismael Jiménez-Ruiz
- ENFERAVANZA, Murcia Institute for BioHealth Research (IMIB-Arrixaca), Faculty of Nursing, University of Murcia, El Palmar, 30120 Murcia, Spain
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Almeer HH, Almulla AA, Almugahwi AA, Alzaher MZ, Alshammasi MM, Menezes RG. Female Genital Mutilation in Saudi Arabia: A Systematic Review. Cureus 2021; 13:e19300. [PMID: 34900477 PMCID: PMC8649978 DOI: 10.7759/cureus.19300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2021] [Indexed: 11/05/2022] Open
Abstract
Female genital mutilation (FGM) or circumcision refers to the unnecessary procedure that damages or removes the external genitalia of females. It is mostly practiced in African countries and some Asian regions, particularly the Middle East, and is performed because of cultural, religious, and social reasons. FGM can negatively affect the lives of women and lead to devastating consequences, ranging from immediate to long-term complications. These complications can be in the physical, psychological, reproductive, or sexual health domains. In this systematic review, we aim to highlight the prevalence and practice of FGM in Saudi Arabia. We conducted a literature search at PubMed to identify studies related to the practice of FGM reported from Saudi Arabia. The results indicate that FGM can still be found in Saudi Arabia both in Saudi women and non-Saudi residents. Most of the non-Saudi women with FGM were Sudanese, Somali, Eritrean, and Egyptian. FGM is prevalent in regions such as Jeddah and Hali, Al Qunfudhah Governorate, Saudi Arabia. FGM is considered illegal in most countries around the world. However, in Saudi Arabia, there is no clear and specific law against the practice of FGM. More research on the practice of FGM in Saudi Arabia needs to be conducted to get a better grasp of the true nature of the problem in the country, which could potentially lead to specific and clear legislation that would prevent the social evil of FGM in Saudi Arabia.
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Affiliation(s)
- Hashim H Almeer
- Internal Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Ali A Almulla
- Internal Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | | | - Mohamad Z Alzaher
- Internal Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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Ahmed CA, Khokhar AT, Erlandsson K, Bogren M. Defibulated immigrant women's sexual and reproductive health from the perspective of midwives and gynaecologists as primary care providers in Sweden - A phenomenographic study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100644. [PMID: 34265570 DOI: 10.1016/j.srhc.2021.100644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/19/2021] [Accepted: 06/28/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To capture care providers' perceptions of defibulated immigrant women's sexual and reproductive health, illuminated by their experiences as care providers for these women. METHODS Individual interview study with 13 care providers at Swedish healthcare facilities: six gynaecologists and seven midwives caring for defibulated immigrant women, analysed with a phenomenographic method. FINDINGS One of the care providers' perceptions of women who had been defibulated was that they had an altered genital function, meaning a wider introitus, improved vaginal intercourse, and more ease urinating and menstruating. The care providers also perceived that women who were defibulated had to balance their wellbeing, struggling between a positive self-image and handling their emotions. Existing in-between cultural values led to a fear of being excluded while at the same time having a desire to be included in the new culture. CONCLUSION Defibulation affects women's sexual and reproductive health and calls for a holistic perspective when providing services, individualized according to the woman's care needs. Support and counselling, should include information about defibulation already during the adolescent years to promote sexual and reproductive health and well-being.
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Affiliation(s)
- Caisha Arai Ahmed
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | - Kerstin Erlandsson
- Women's and Children's Health, Karolinska Institutet, Solna, Sweden; School of Education, Health and Social Studies, Dalarna University, Dalarna, Sweden.
| | - Malin Bogren
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
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Effects of clitoral reconstruction for female genital mutilation on perinatal outcomes: A retrospective case-control study. J Gynecol Obstet Hum Reprod 2020; 50:101954. [PMID: 33080401 DOI: 10.1016/j.jogoh.2020.101954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate the perinatal outcomes of women with a history of female genital mutilation (FGM) who underwent clitoral reconstruction (CR) compared with women with FGM who did not undergo CR. MATERIAL AND METHODS Retrospective case-control study at Angers University Hospital, between 2005 and 2017. INCLUSION CRITERIA pregnant women >18 years who underwent CR after FGM. Only the first subsequent delivery after CR was included. Each woman with CR was matched for age, ethnicity, FGM type, parity, and gestational age at the time of delivery with two women with FGM who did not undergo CR during the same period of time. At birth, the main outcomes were the need for episiotomy and having an intact perineum after delivery. RESULTS 84 women were included (28 in the CR group; 56 in the control group). In the CR group, patients required significantly fewer episiotomies (5/17[29.4 %]) compared to the control group (28/44[63.6 %], p = 0.02), even after excluding operative vaginal deliveries (2/13[15.4 %] vs 21/36[58.3], p < 0.01). CR reduces the risk of episiotomy (aOR = 0.15, 95 %CI [0.04-0.56]; p < 0.01) after adjusting on the infant weight and the need for instrumental delivery. In the CR group, 47 % of the patients had an intact perineum after delivery, compared to 20.4 % in the control group (p = 0.04). CR increases the odds of having an intact perineum at birth by 3.46 times (CI95 %[1.04-11.49]; p = 0.04). CONCLUSION CR after FGM increases the chances of having an intact perineum after delivery by 3.46 times and reduces the risk of episiotomy by 0.15 times compared to women with FGM who did not underwent CR.
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Akpak YK, Yenidede I, Kilicci C. Evaluation of etiology, characteristics, and treatment of patients with vesicovaginal fistula observed in rural Africa. J Gynecol Obstet Hum Reprod 2020; 50:101879. [PMID: 32712179 DOI: 10.1016/j.jogoh.2020.101879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/15/2020] [Accepted: 07/21/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In this study, we aimed to evaluate the etiology, characteristics, and treatment of patients with diagnosis of vesicovaginal fistula (VVF) due to labor in rural Africa following surgery in a hospital with western standards according to the current literature. METHODS In this retrospective large case series, 56 patients undergoing surgery due to prediagnosis of VVF and then followed-up regularly in Nyala-Sudan Turkey Training and Research Hospital between December 2018 and February 2019 were evaluated. The information related to the ages, mode, and the number of deliveries, previous histories of fistula repair surgery, postoperative success and complication rates were gathered. RESULTS The absence of urine from the vagina during the examination with methylene blue was defined as success. The overall success rate was 84.3 %. The vaginal route was most commonly preferred for fistula repair surgery and its success rate and efficiency were found to be higher. In addition, a low complication rate was observed as 3.9 %. A higher rate of association was observed between Female Genital Mutilation/Cutting (FMG/C) and fistula. Especially FGM/C type 3 was frequently seen with a rate of 61.7 %. This type of FGM/C was observed in all patients undergoing reoperation. The main causes of recurrence of fistula were vaginal delivery within 6 months of repair or presence of multiple fistulas at diagnosis. CONCLUSIONS The surgery and follow-up process should be individualized after this examination based on the condition, clinical picture of the patient and surgeon's experience. Additionally worldwide steps should be taken to prevent FGM/C as it is associated with many undesired outcomes including VVF.
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Affiliation(s)
- Yasam Kemal Akpak
- University of Health Science, Tepecik Training and Research Hospital, Department of Obstetrics and Gynaecology, Izmir, Turkey; University of Health Science, Nyala Sudan-Turkey Training and Research Hospital, Department Obstetrics and Gynaecology, Nyala, Sudan.
| | - Ilter Yenidede
- Zeynep Kamil Women and Children's Disease Training and Research Hospital, Department Obstetrics and Gynaecology, Istanbul, Turkey
| | - Cetin Kilicci
- Zeynep Kamil Women and Children's Disease Training and Research Hospital, Department Obstetrics and Gynaecology, Istanbul, Turkey
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